The description of Lyme disease in 1976 and subsequent characterization of its mode of transmission, causative organism and treatment is one of the most important advances in rheumatology in the last 20 years. In theory Lyme disease could be prevented eradicated but in practice it continues to grow as public health problem. We propose a large simple randomized controlled trail of 40,000 subjects to evaluate an innovative educational primary prevention program directed towards a high-risk population, travelers to an island with the highest reported rates of Lyme disease in North America. Ferry boats to Nantucket Island will be randomized to Experimental intervention which is based on contemporary health education principles or to a Control intervention. An economic evaluation will be conducted in the context of the trial.